Problems with 988 crisis hotline start-up

Steve Corbin is emeritus professor of marketing at the University of Northern Iowa and a freelance writer who receives no remuneration, funding, or endorsement from any for-profit business, nonprofit organization, political action committee, or political party.

Most people have memorized their Social Security number, cell phone number, anniversary, birthday and the 911 emergency medical, fire and police protection services number. On July 16, the number “988” became an easy-to-remember crisis hotline number we should log into our memory bank.

Anyone who needs support for a suicidal, mental health, substance use crisis, or other emotional issue can dial or text 988. The nationwide set-up should strengthen and expand the existing Lifeline system, which is a national network of more than 200 local, independent and state-funded crisis centers.

Both the new 988 hotline number and the previous ten-digit number (800-273-8255) will remain in operation, providing 24/7 free and confidential support for people in distress.

Johns Hopkins Medicine reports that an estimated 26 percent of Americans over age 18 suffers from a diagnosable mental disorder. According to Mental Health America’s 2022 State of Mental Health Report, the U.S. has witnessed nearly a 5 percent increase of adults having serious thoughts of suicide every year since 2011. In 2020 alone, one American died by suicide about every 11 minutes. It is a leading cause of death for 10-34 year-olds and veterans.

However, problems abound with America’s readiness for the 988 hotline number, which the U.S. House and Senate unanimously approved in 2020. Despite a federal mandate and $430 million allocated to states to expand their crisis networks, Megan Messerly and Sarah Owermohle reported for Politico, “federal officials say few states have kept their end of the bargain and implemented long-term funding.”

Alabama, Arkansas, Florida, Iowa, and Missouri are among 29 states—mostly Republican controlled—that did not introduce any legislation to address 988 hotline funding. “Only 21 states have enacted legislation to ensure local call centers will be fully funded,” Tina Reed reported for Axios. Natalie Krebs reported for Iowa Public Radio on concerns expressed by contractors who are setting up Iowa’s 988 call centers.

A second problem: Wall Street Journal data revealed about one is six calls to the heretofore 10-digit national mental-health crisis line weren’t answered. It’s tragic this mishandling of calls was not rectified prior to implementing the new 988 hotline.

Third, state and federal officials project the 988 easy-to-memorize hotline number will create an increase from over 3.3 million contacts per year to 6 to 12 million calls, texts, or chats annually. According to a recent Rand report, “fewer than half of the public health officials responsible for deploying 988 say they are confident their communities have the necessary staff, financing or equipment to field the anticipated surge of calls.”

Finally, U.S. Secretary of Health and Human Services Xavier Becerra has expressed concern that more than half of the states were sending most of their crisis calls to fifteen out-of-state backup call centers. From the article by Messerly and Owermohle: “state health officials say in-state call centers are more familiar with the local services, including the availability of mobile response teams, psychiatric urgent care facilities and crisis stabilization beds.”

On a positive note, Lindsey Tanner of the Associated Press reported that “988 will connect callers with trained mental health counselors,” as opposed to the police, firefighters, or paramedics who are typically dispatched after 911 calls. Experts estimate that at least a third of 911 emergency calls to which police respond could be safely directed to mental-health first responders, reducing the risk of a tragic encounter with police.

Mental health is a serious issue. It’s a shame—make that gross negligence—that 29 state legislatures (including Iowa’s) did not address fully funding the federal mandate to protect their citizens with mental health conditions. No governor is exempt from blame, since the U.S. Department of Health and Human Services sent a letter to every governor telling them how their mental health hotlines’ ranked.

Memorize 988. You may need that number to save a loved one, or even yourself.

About the Author(s)

Steve Corbin